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Consensus on the histopathological evaluation of liver biopsies from patients following allogeneic hematopoietic cell transplantation

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Abstract

After allogeneic hematopoietic cell transplantation (alloHCT) liver biopsy is performed for enigmatic liver disorders when noninvasive diagnostic steps have failed in establishing a definitive diagnosis. This document provides an updated consensus on the prerequisites for proper evaluation of liver biopsies in alloHCT patients and the histological diagnostic criteria for liver graft-versus-host disease (GvHD). The Working Group’s recommendations for the histological diagnosis of liver GvHD were derived from the peer-reviewed literature and from the consensus diagnosis of a total of 30 coded liver biopsies. Acceptance of the recommendations was tested by a survey distributed to all HCT centers in Austria, Germany and Switzerland. Consensus was achieved for biopsy indications, methods of sample acquisition and processing, reporting and interpretation of biopsy findings. As GvHD is variably treated and the treatment modalities have changed over time, the panel endorses the use of more frequent biopsies in clinical studies in order to improve the present challenging clinical and diagnostic situation.

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Conflicts of interest

D.W. serves as consultant for Falk Pharma. The remaining authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Clinical Pathology, Medical University of Vienna, Vienna, Austria

    Judith Stift & Fritz Wrba

  2. Department of Pathology and Neuropathology, Essen University Hospital, Essen, Germany

    Hideo A. Baba

  3. Institute of Pathology, University of Regensburg, Regensburg, Germany

    Elisabeth Huber

  4. Institute of Pathology, University of Tübingen, Tübingen, Germany

    Birgit Federmann & Falko Fend

  5. Institute of Pathology, University of Bonn, Bonn, Germany

    Hans-Peter Fischer

  6. Institute of Pathology, University Medical Center Freiburg, Freiburg, Germany

    Annette Schmitt-Graeff

  7. German Clinic for Diagnostic, BMT Unit, Wiesbaden, Germany

    Herrad Baurmann & Rainer Schwerdtfeger

  8. Department of Medicine, University Hospital Tübingen, Tübingen, Germany

    Wolfgang Bethge

  9. Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany

    Peter Schirmacher & Thomas Longerich

  10. Department of Internal Medicine I, Bone Marrow Transplantation, Medical University of Vienna, Vienna, Austria

    Hildegard Greinix

  11. Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA

    Howard M. Shulman

  12. Department of Internal Medicine III, University of Regensburg, Regensburg, Germany

    Daniel Wolff

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  1. Judith Stift
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on behalf of the Liver Pathology Group of the German-Austrian-Swiss Working Group on GvHD

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Correspondence to Thomas Longerich.

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Stift, J., Baba, H.A., Huber, E. et al. Consensus on the histopathological evaluation of liver biopsies from patients following allogeneic hematopoietic cell transplantation. Virchows Arch 464, 175–190 (2014). https://doi.org/10.1007/s00428-013-1528-8

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